转移性椎体压缩性骨折患者骨水泥增强椎弓根螺钉固定后肺水泥栓塞：1例报告及处理考虑

IF 0.7 Q4 SURGERY

Journal of Vascular Surgery Cases Innovations and Techniques Pub Date : 2025-05-16 DOI:10.1016/j.jvscit.2025.101845

Mohammad Daher BS , Victor Percheron MD , Adrien Lampilas MD , Amer Sebaaly MD , Guillaume Riouallon MD , Stéphanie Bonhomme MD , Maxime Delrue MD, PhD

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引用次数: 0

摘要

我们报告一例61岁女性转移性直肠腺癌患者，因L3椎体压缩性骨折接受手术固定和椎板切除术。椎弓根螺钉用水泥加固。随后的计算机断层扫描在右肺动脉发现了偶然的肺水泥栓塞。患者仍无症状，并进行了抗凝治疗。随后的胃肠道出血需要暂时停止抗凝治疗，但由于栓子的持续存在，预防性抗凝治疗得以恢复。随访6个月，患者病情稳定，无出血性并发症。对于无症状的中枢性肺水泥栓塞，抗凝可能是适当的，但需要仔细的风险评估和多学科管理，以平衡血栓和出血的风险。

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Pulmonary cement embolism following cement-augmented pedicle screw fixation in a patient with metastatic vertebral compression fracture: A case report and management considerations

We report the case of a 61-year-old female with metastatic rectal adenocarcinoma who underwent surgical fixation and laminectomy for an L3 vertebral compression fracture. Pedicle screws were augmented with cement. Follow-up computed tomography later detected an incidental pulmonary cement embolism in the right pulmonary artery. The patient remained asymptomatic and was managed with anticoagulation therapy. Subsequent gastrointestinal bleeding required temporary cessation of anticoagulation, but prophylactic anticoagulation was resumed due to the persistent embolus. At 6-month follow-up, the patient remained stable without hemorrhagic complications. In asymptomatic central pulmonary cement embolisms, anticoagulation may be appropriate but requires careful risk assessment and multidisciplinary management to balance the risks of thrombosis and bleeding.

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来源期刊

Journal of Vascular Surgery Cases Innovations and Techniques SURGERY-

CiteScore

1.00

自引率

14.30%

发文量

219

审稿时长

29 weeks

期刊介绍： Journal of Vascular Surgery Cases and Innovative Techniques is a surgical journal dedicated to publishing peer review high quality case reports, vascular images and innovative techniques related to all aspects of arterial, venous, and lymphatic diseases and disorders, including vascular trauma, malformations, wound care and the placement and maintenance of arterio-venous dialysis accesses with an emphasis on the practicing clinician. The Journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals involved with the management of patients with the entire spectrum of vascular disorders.